0001140361-23-020316.txt : 20230425
0001140361-23-020316.hdr.sgml : 20230425
20230425184459
ACCESSION NUMBER: 0001140361-23-020316
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230421
FILED AS OF DATE: 20230425
DATE AS OF CHANGE: 20230425
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Bizily Scott
CENTRAL INDEX KEY: 0001920738
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39782
FILM NUMBER: 23846295
MAIL ADDRESS:
STREET 1: C/O 4D MOLECULAR THERAPEUTICS, INC.
STREET 2: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: 4D Molecular Therapeutics, Inc.
CENTRAL INDEX KEY: 0001650648
STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836]
IRS NUMBER: 473506994
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
BUSINESS PHONE: 5105052680
MAIL ADDRESS:
STREET 1: 5858 HORTON STREET #455
CITY: EMERYVILLE
STATE: CA
ZIP: 94608
FORMER COMPANY:
FORMER CONFORMED NAME: 4D Molecular Therapeutics Inc.
DATE OF NAME CHANGE: 20200506
FORMER COMPANY:
FORMER CONFORMED NAME: 4D Molecular Therapeutics Inc
DATE OF NAME CHANGE: 20150811
4
1
form4.xml
X0407
4
2023-04-21
0001650648
4D Molecular Therapeutics, Inc.
FDMT
0001920738
Bizily Scott
C/O 4D MOLECULAR THERAPEUTICS INC.
5858 HORTON STREET #455
EMERYVILLE
CA
94608
true
Chief Legal and HR Officer
true
Common Stock
2023-04-21
4
M
0
3750
8.04
A
5859
D
Common Stock
2023-04-21
4
S
0
3750
20
D
2109
D
Stock Option (Right to Buy)
8.04
2023-04-21
4
M
0
3750
0
D
2032-08-31
Common Stock
3750
52500
D
Transaction made pursuant to a 10b5-1 trading plan adopted by the Reporting Person on October 13, 2022.
The shares underlying the stock option award shall vest and become exercisable as to 1/48th of the underlying shares on each monthly anniversary of September 1, 2022 (the "Vesting Commencement Date") such that 100% of the shares subject to the option will be fully vested and exercisable on the fourth anniversary of the Vesting Commencement Date, while the grantee remains a service provider to the Company.
/s/ August J. Moretti, Attorney-in-Fact for Scott Bizily
2023-04-25